The present application relates, in general, to surgical devices for forming an anastomosis between internal body lumens and, more particularly, to devices that can be inserted through a natural orifice in the body and used to form an anastomosis between various gastrointestinal lumens.
Access to the abdominal cavity may be required for diagnostic and therapeutic endeavors for a variety of medical and surgical diseases. Historically, abdominal access has required a formal laparotomy to provide adequate exposure. Such procedures, which require incisions to be made in the abdomen, are not particularly well-suited for patients that may have extensive abdominal scarring from previous procedures, those persons who are morbidly obese, those individuals with abdominal wall infection, and those patients with diminished abdominal wall integrity, such as patients with burns and skin grafting. Other patients simply do not want to have a scar if it can be avoided.
Minimally invasive procedures are desirable because such procedures can reduce pain and provide relatively quick recovery times as compared with conventional open medical procedures. Many minimally invasive procedures are performed with an endoscope (including without limitation laparoscopes). Such procedures permit a physician to position, manipulate, and view medical instruments and accessories inside the patient through a small access opening in the patient's body. Laparoscopy is a term used to describe such an “endosurgical” approach using an endoscope (often a rigid laparoscope). In this type of procedure, accessory devices are often inserted into a patient through trocars placed through the body wall. The trocar must pass through several layers of overlapping tissue/muscle before reaching the abdominal cavity.
Still less invasive treatments include those that are performed through insertion of an endoscope through a natural body orifice to a treatment region. Examples of this approach include, but are not limited to a gastro-jejunostomy, jejuno-jejunostomy, cholecystectomy, appendectomy, cystoscopy, hysteroscopy, esophagogastroduodenoscopy, and colonoscopy. Many of these procedures employ the use of a flexible endoscope during the procedure. Flexible endoscopes often have a flexible, steerable articulating section near the distal end that can be controlled by the user by utilizing controls at the proximal end. Minimally invasive therapeutic procedures to treat diseased tissue by introducing medical instruments to a tissue treatment region through a natural opening of the patient (e.g., mouth, anus, vagina) are known as Natural Orifice Translumenal Endoscopic Surgery (NOTES)™ procedures. Medical instruments such as endoscopic needles may be introduced through the working channel of a flexible endoscope, which typically has a diameter in the range of approximately 2.5 millimeters (“mm”) (or approximately 0.10 inches (“in”)) to approximately 4.0 mm (or approximately 0.16 in).
These minimally invasive surgical procedures have changed some of the major open surgical procedures such as gastro-jejunostomy or jejuno-jejunostomy, to simple outpatient surgery. Consequently, the patient's recovery time has changed from weeks to days. These types of surgeries are often used for creating an anastomosis between the stomach and the jejunum and/or between a portion of the jejunum and another portion of the jejunum.
In the past, such surgical procedures were also employed to address various problems occurring in the jejunum (a portion of the small intestine). For example, such procedures were commonly employed to address blockages or strictures in the jejunum or to address diseases occurring therein. In some situations, it becomes necessary to create a gastro-jejunostomy—an anastomosis between the stomach and the jejunum—or a jejuno-jejunostomy—an anastomosis between one portion of the jejunum and another portion of the jejunum. In addition to suffering from the above-mentioned limitations, current laparoscopic and endoscopic surgical techniques also fail to provide a convenient way for inserting a distal mass and are generally incapable of applying sufficient mass and force to effect a clinically acceptable compression anastomosis.
Consequently a significant need exists for an alternative to conventional surgery that eliminates abdominal incisions and incision-related complications by employing an endoscopic technique to treat an abdominal pathology.
There is a further need for a surgical device that can be introduced into the stomach through the mouth and used to form a clinically acceptable compression anastomosis between the stomach and the jejunum and/or a portion of the jejunum and another portion of the jejunum.
The foregoing discussion is intended only to illustrate some of the shortcomings present in the field of the invention at the time, and should not be taken as a disavowal of claim scope.